Gastric sleeve surgery is a tool designed to help you lose substantial amounts of weight and become healthy. So why do I talk about exercise so much, especially considering that “abs are made in the kitchen”? While it’s true that what you eat has much more impact on how many pounds you shed than exercise does, it’s a huge part of long-term physical and mental wellness. So here are answers to some of the most frequently asked questions about fitness.

Question #1: When will I be cleared for exercise after surgery? Walking is encouraged pretty much as soon as you wake up from anesthesia. As I’ve said many times, we don’t use urinary catheters during the gastric sleeve procedure, and most people have to pee within a few hours of surgery. Guess what? You get to walk to the bathroom! And, no, the vast majority of my patients don’t have any trouble with it. From then on, I want you to walk as much as you comfortably can. Take it slowly, but the general rule is that the more you walk, the better you’ll feel. When you get home, start strolling around the neighborhood. After a week or two, increase those strolls to 15 minutes and work your way up to 45 minutes to an hour most days of the week. Assuming that your healing is progressing as expected, of course. If you’re a swimmer (or want to become one), you can start this low-impact workout as soon as your surgery incisions are healed—about 15 days post-surgery. Any sooner and you risk an infection.

Question #2: Can I return to high-intensity workouts like spinning right away? The short answer is “no,” and the longer answer is “pace yourself.” If you were a spinning enthusiast before surgery, I understand that you would want to pick it up as soon as possible. Start with a lower intensity exercise such as walking or swimming for the first few weeks. And when you’re ready to hop back on the spinning bike, don’t expect to pick up where you left off. Between your last class and now, you’ve had surgery and have been consuming far fewer calories than you were before. So your energy levels just won’t be the same. They’ll return, so don’t push the panic button. And remember that exercise is something you’ll be doing for the rest of your life, so there’s no need to jump in with an hour-long session your first time back at the gym.

Question #3: When can I do crunches? Not for about a month. Things like crunches and heavy resistance training affect your body more like high-impact activities (not to be confused with high-intensity activities like the spinning question above). The main reason to wait is that your largest incision takes that long to heal, and stressing it before it’s healed can increase your risk of hernia. The same restriction applies to high-impact sports like football, boxing, karate, martial arts, etc. Keep your exercise low-key until you’re at least a month out, and then start back to weights and abdominal work slowly. Even if you’ve been a weightlifter for a long time, taking a month off from training will set you back significantly. My best advice is to enlist the help of a trainer who knows how to work with people after weight loss surgery. He or she can help you design a strength training plan that takes into account not only your recent gastric sleeve procedure, but your exercise history and goals.

Question #4: Can exercising help me prevent loose skin? Somewhat. If you lose hundreds of pounds, chances are pretty good that you’ll end up with loose skin that you can either learn to love or remove through skin removal surgery. That said, exercise is your best shot at minimizing the amount of loose skin you end up with and can help eliminate the issue in those with fewer overall pounds to shed. A combination of cardio and resistance training (such as lifting weights or bodyweight exercises like pushups) tones your body while you drop fat. Again, if minimizing loose skin is a high priority for you, invest in a personal trainer who can design a program for your goals.

Finally, what’s the “best” kind of exercise? The one that you’ll actually do. So keep searching until you find a regimen you can keep up for life because studies prove that people who exercise regularly not only live longer and experience fewer health problems, but they’re able to maintain their weight loss indefinitely.

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